The Use of Clear Aligner Therapy for Orthognathic Surgery Patients: A Cross-Sectional Survey Among Saudi Orthodontists and Oral and Maxillofacial Surgeons.

BACKGROUND

Orthognathic surgery corrects severe skeletal discrepancies that cannot be addressed by orthodontics alone. With advancements in digital workflows and CAD/CAM technologies, clear aligner therapy (CAT) has emerged as a potential adjunct in surgical cases. However, its clinical application remains under-researched. This study aimed to exploratorily assess the knowledge, clinical experience, and attitudes of orthodontists and oral and maxillofacial surgeons in Saudi Arabia regarding CAT in orthognathic surgery patients.

METHODS

A cross-sectional survey was conducted from April 1 to May 31, 2023, using a closed-ended online questionnaire distributed to specialists across Saudi Arabia. The survey gathered demographic and clinical data. Statistical analysis included descriptive methods, chi-square testing, and univariate regression. Given the limited sample size, inferential analyses were performed for exploratory purposes and interpreted cautiously.

RESULTS

Out of 278 invited participants, 46 complete responses (16.5%) were received, which was substantially lower than the calculated minimum sample size. Most participants were aged 31-40 years and had 6-10 years of experience. Orthodontists accounted for 65.2% of the respondents, with oral and maxillofacial surgeons at 34.8%. While most treated 1-4 orthognathic patients monthly, 80% had no experience using CAT in these cases Although CAT was commonly used in routine orthodontic practice, its application in orthognathic surgery cases was limited. Exploratory regression analysis suggested a possible association between clinician age and CAT usage (R 2 = 0.38), whereas gender and years of experience did not show clear associations.

CONCLUSION

This exploratory survey suggests that clinical experience with CAT in orthognathic surgery remains limited among surveyed clinicians in Saudi Arabia. The findings highlight perceived challenges related to surgical workflows, including pre-surgical alignment, intraoperative fixation, and postoperative occlusal control. Given that the achieved sample size (n = 46) was substantially lower than the calculated minimum requirement (n = 302), the results should be interpreted as preliminary observations and exploratory findings rather than definitive conclusions. Findings should be interpreted cautiously due to the small sample size and exploratory design.